Sicher-Targ distant healing report

“My goal is simply to pave the way for free
and fair scientific discourse on subjects that have previously been
considered nonrational. It's our responsibility as scientists and
physicians to speak based on fact, not opinion. If there's a benefit to
distant healing, physicians and patients should consider it along with all
the other proven treatments for disease.” --Elisabeth
Targ

This very deceptive report is
"widely acknowledged as the most scientifically rigorous attempt ever to
discover if prayer can heal" (Bronson
2002). If that is true, rigor has become rigor mortis in this branch of
scientific research. The study included only 40 subjects, so no matter how
rigorous the design of the study, the likelihood that anything of major
significance could be drawn from it would be remote. Furthermore, the study
isn't specifically about prayer anyway. Both prayer and 'psychic healing'
are mentioned in the abstract to the report, but prayer is not specified in
the study as a method of healing they were testing. Since some of the
healers were Christians and Jews, one might reasonably infer that some of
the healers were using prayer in their efforts at healing someone from a
distance. On the other hand, it seems rude to quibble over whether
'prayer' should be used to describe the various practices of the healers. If
we define distant healing to include any effort to direct one's intentions
toward the improved health and well being of others, then distant healing might
beconsidered a type of intercessory prayer.

The research took place from July
1996 through January 1997 and was published inThe Western Journal of
Medicine in December 1998 as “A Randomized Double-Blind Study of the
Effect of Distant Healing in a Population With Advanced AIDS--Report of a
Small Scale Study.” The main research scientists and authors were
psychologist Fred Sicher, M.A., and psychiatrist Dr. Elisabeth Targ. The
study was supposed to be a replication of an earlier "double-blind study of
10 treated and 10 control subjects conducted during July 1995 through
January 1996."

What was the treatment? It's hard to
say, since various people at various distances from the subjects engaged in various sorts
of activities; they were instructed to "direct an intention for health
and well-being" toward the subject. This is called "distant healing" or DH.

What were the patients being treated for?
This iswhere it gets tricky. The first study looked at mortality:
Would the prayers help AIDS patients live longer? In the first study, four patients died
out of the ten in
the control group, while none died in the DH group. Sicher and Targ bankrolled that into a grant from NIH to do a
follow-up study, even though in the first study they hadn't controlled for age and the four who
died were the four oldest in the study. Worse than that, the NIH
acknowledges that the first thing most people do when they get really sick
is start praying and asking others to pray for them. Prayer, according to
the NIH, is the number one alternative therapy in America. The implication
of this is that prayer can't be controlled for, making a controlled study on
the effects of prayer and other DH techniques impossible. Clearly, the standards at NIH are not
that high in the "alternative therapy" division.

Some critics might balk at such a
study, believing that these scientists were testing some god. That seems to have
been the idea in some other prayer studies, such as
the Byrd study.
But the Sicher-Targ report does not mention any god, nor do the authors imply
that they have any idea how prayer or any other distant healing practice
might work. One gets the feeling that they think it has something to do with
energies, but it's all left very vague. Here is
how the report describes the healers and the healing:

Healers

Forty DH practitioners, including 12 from the pilot
study, were recruited via professional healing associations and schools of
healing. Eligibility criteria were minimum 5 years regular ongoing healing
practice, previous healing experience at a distance with at least l0
patients, and previous healing experience with AIDS. Healers had an
average of 17 years of experience and had previously treated an average of
106 patients at a distance. Practitioners included healers from Christian,
Jewish, Buddhist, Native American, and shamanic traditions as well as
graduates of secular schools of bioenergetic and meditative healing.
Practitioners were not paid and understood that the study could not
evaluate the abilities of any individual practitioner. Healers were
residing at various locations throughout the United States. The site from
which they performed their healing was not restricted.

Healing treatment

A rotating healing schedule randomized healers to
subjects on a weekly basis to minimize possible differences in healer
effectiveness. Thus, each subject in the DH group was treated by a total
of 10 different practitioners, while each practitioner worked every other
week treating a total of 5 subjects. Each healer received five
consecutively numbered subject information packets with instructions
specifying the day to begin treatment on each subject. Healers were asked
to work on the assigned subject for approximately 1 hour per day for 6
consecutive days with the instruction to "direct an intention for health
and well-being" to the subject. Healers completed logs for each healing
session, indicating period of healing, specific technique, and any
impressions of the subject's illness. Subjects never met practitioners and
did not know whether they were in the DH group, where the practitioners
were located, nor at what time the DH might occur. Before the
intervention, study personnel encouraged and motivated healers via letters
and phone calls stressing the importance of the study and their individual
efforts.

The 1998 Sicher-Targ study appears
to be an extremely well-designed double-blind, controlled study. Even so, it
is very unclear exactly what causal processes were to be measured. Worse, the researchers—at Targ’s
urging—changed the goal of the study and had a statistician mine the data
after it had been completed. As noted above, the original goal was to
see if DH could lower the death rate for AIDS patients. Since only one
of the patients in the study died, there was nothing to report on that
count. The published study, however, claimed that the aim was to measure
DH against a long list of AIDS-related symptoms. A biased researcher (Sicher)
went through all the data after the study was completed to determine
which patients had which symptoms. It was a bit of a fluke that Sicher and
Targ’s deception was exposed by
Po
Bronson in Wired magazine four years after the study was
published. By that time, Targ had bankrolled it into another big grant from
NIH.

The results must have seemed
impressive to the folks at NIH and to believers in distant healing
everywhere. The abstract for the Sicher-Targ report notes that controls were
done for age, number of AIDS-defining illnesses, and T cell count. Patients
were randomly assigned to the control or DH groups. The study
followed the patients for six months. "At 6 months, a blind medical chart
review found that treatment subjects acquired significantly fewer new
AIDS-defining illnesses (0.1 versus 0.6 per patient, P = 0.04), had lower
illness severity (severity score 0.8 versus 2.65, P = 0.03), and required
significantly fewer doctor visits (9.2 versus 13.0, P = 0.01), fewer
hospitalizations (0.15 versus 0.6, P = 0.04), and fewer days of
hospitalization (0.5 versus 3.4, P = 0.04)."

These numbers are very impressive.
They indicate that the measured differences were not likely due to chance.
Whether they were due to healing prayer (HP) is another matter, but the
scientists concluded their abstract with the claim: "These data support the
possibility of a DH effect in AIDS and suggest the value of further
research."

Po Bronson put it this way:

The research results showed that
the subjects who were not prayed for spent 600 percent more days in the
hospital. They contracted 300 percent as many AIDS-related illnesses.
That's a pretty sensationalistic way of saying those who were prayed for
were a lot less sick. Here's the somewhat less-sensational way of framing
the results: The control group spent a total of 68 days in the hospital
receiving treatment for 35 AIDS-related illnesses. The treatment group
spent only 10 days in the hospital for a mere 13 illnesses.

Two years after the publication of these sensational
sounding results, Elisabeth Targ was granted $1.5 million from the National
Institutes of Health Center for Complementary and Alternative Medicine to do
two further studies on the healing effects of prayer. Both studies would
involve 150 subjects. One was going to involve AIDS patients and the other
was going to involve patients with brain cancer. Ironically, Targ died of a
brain tumor in 2003, despite being one of the most prayed-for persons on the
planet. Rather than take this as a sign that maybe this prayer therapy isn't
so effective, her husband Mark Comings—they married shortly before her
death—now gives presentations where he discusses communications he has been
receiving from Elisabeth since she died (Solstice).
This shouldn't be surprising. Comings is "a theoretical physicist. He felt
that an eight-dimensional universe could explain how a healer in Santa Fe
could influence a patient in San Francisco: In our ordinary
three-dimensional world, healer and patient appear far apart, but in one of
the as-yet-unmeasurable extra dimensions, they'd be in the same place"
(Bronson).

What the Sicher-Targ report didn't reveal was that the
original study had not been designed to do any of these measurements they
report as significant. Of course, any researcher who didn't report
significant findings just because the original study hadn't set out to
investigate them would be remiss. The standard format of a scientific report
allows such findings to be noted in the abstract or in the discussion
section of the report. Thus, it would have been appropriate for the
Sicher-Targ report to have noted in the discussion section that since only
one patient died during their study, it appears that the new drugs being
given AIDS patients as part of their standard therapy (triple-drug
anti-retroviral therapy) were having a significant effect on longevity.
They might even have suggested that their finding warranted further research
into the effectiveness of the new drug therapy.

However, in the introductory remarks, the Sicher-Targ
report gives the impression that the researchers already knew the new drug
therapy would work (making them clairvoyant!) and that is why they changed
the design from the earlier pilot study. They now claim they never intended
to replicate that study. Instead, they write:

an
important intervening medical factor changed the endpoint in the study
design. The pilot study was conducted before the introduction of
"triple-drug therapy" (simultaneous use of a protease inhibitor and at least
two antiretroviral drugs), which has been shown to have a significant effect
on mortality. [Here, they cite a
study published in September of 1997, which is nine months after their study was
supposedly completed! Again, proof of their clairvoyance!] For the replication study
(July 1996 through January 1997, shortly after widespread introduction of
triple-drug therapy in San Francisco), differences in mortality were not
expected and different endpoints were used in the study design.

The above description of why they
changed the endpoint is grossly misleading. It was only after they
mined the data once the study was completed that they came up with the
suggestive and impressive statistics that they present in their published
report. Under certain conditions, mining the data would be perfectly
acceptable. For example, if the original study was designed to study the
effectiveness of a drug on blood pressure but found that the experimental
group had no significant decrease in blood pressure but did have a
significant increase in HDL (the so-called "good" cholesterol), you would be
remiss not to mention this. You would be guilty of deception, however, if
you wrote your paper as if your original design was to study the effects of
the drug on cholesterol and made no mention of blood pressure.

Thus, it would have been entirely
appropriate for Sicher and Targ to have noted in the discussion section of
their report that they had discovered something interesting that they hadn't
set out to examine: Hospital stays and doctor visits were lower for the DH
group. It was inappropriate to write the report as if that was one of the
effects the study was designed to measure when this effect was neither
looked for nor discovered until Moore, the statistician for the study, began
crunching numbers looking for something of statistical significance after
the study was completed. Again, crunching numbers and data mining after a
study is completed isn't always inappropriate; not mentioning that you
rewrote your paper to make it look like it had been designed to crunch those
numbers is always wrong. If you engage in such behavior it would be
appropriate to ask people who pray to pray for you.

Also, it would have been appropriate
in the discussion section of their report to have speculated as to the
reason for the statistically significant differences in hospitalizations and
days of hospitalization. Sicher and Targ could have speculated that DH
made all the difference but, if they were competent, they would have also
noted that insurance coverage could make all the difference as well.
"Patients with health insurance tend to stay in hospitals longer than
uninsured ones" (Bronson 2002). The researchers should have checked this out
and reported their findings. Had they been competent researchers and had
hospital visits been one of their original data points, they should have pair
matched the control and experimental groups for insurance coverage. With
such a small study, randomly assigning the patients to their groups isn't
sufficient to protect against biasing the sample.

What Sicher did was to take a list
of 23 illnesses associated with AIDS and go back over each patient's medical
chart to collect data for the 23 illnesses as best he could. This was done
after the unblinding of the study, so it was known to Sicher which
group each patient had been randomly assigned to, prayer or control. The
fact that the names were blacked out, so that he could not immediately tell
whose record he was reading, does not seem sufficient to justify allowing
him to review the data and still call the study double-blind. There were
only 40 patients in the study and he was familiar with each of them. Just
looking at their charts could have clued him as to whose chart he was
reading. If there was to be data mining, the one who was to go over the
medical charts should have been an independent party, someone not involved
in the study. Sicher is "an ardent believer in distant healing" and he had
put up $7,500 for the pilot study on prayer and mortality (Bronson). His
impartiality was clearly compromised. So was the double-blind quality of the
study.

Why did they do this? Bronson
describes it this way:

Moore brought Targ and Sicher into
his office and showed him the data on his computer. Moore thought this new
triple-drug therapy was nothing short of a medical miracle, the triumph of
science. It was saving lives! But Targ and Sicher didn't want to see it
that way. Targ asked him to crunch the numbers on the secondary scores -
one a measure of HIV physical symptoms, the other a measure of quality of
life. These came out inconclusive; the treatment group didn't score better
than the control. Not what they wanted to find. In dismay, Targ called her
father [physicist and parapsychologist Russell Targ]. He calmed her down,
told her to keep looking. She had Moore run the mood state scores. These
came out worse - the treatment group was in more psychological stress than
the control group. Same for CD4+ [T cell] counts. Targ flew down to Santa
Fe to attend a conference at a Buddhist retreat run by her godmother. When
she called back to Moore's office, Sicher answered. Moore was crunching
the last data they had, hospital stays and doctor visits. "Looks like we
have statistical significance!" Moore announced. Sicher told Targ, who
turned and yelled out to her friends at the conference.

Even so, true believers continue to
praise the Sicher-Targ report. Some are still promoting Targ's
deceptive
self-assessment of her work, published in the Noetic Sciences Review
(August--November 1999). Here are just a few websites still [as of
4/9/06] promoting
the notion that the Sicher-Targ report found evidence for the effects of
distant healing: